SALUTE DOMANI ∞ IL PORTALE DEL BENESSERE

World Alliance for Breastfeeding Action (WABA) for the protection and support of safe and appropriate infant and young child feeding in emergencies

Emergencies can happen anywhere in the world. Infants and young children are especially vulnerable to malnutrition, illness, and death in these situations. Whatever the emergency –from earthquake to conflict, from floods to the flu pandemic – the story is the same: breastfeeding is a lifeline and a shield that protects infants in emergencies.

From 1-7 August 2009, the World Alliance for Breastfeeding Action (WABA), and breastfeeding advocates in more than 150 countries worldwide will be celebrating World Breastfeeding Week (WBW) for the 18th year. This year, WABA teams up with the Emergency Nutrition Network (ENN) and the International Baby Food Action Network-Geneva Infant Feeding Association (IBFAN-GIFA) who represent an international collaboration of United Nations agencies and non-governmental organisations (IFE Core Group) concerned with protection and support of safe and appropriate infant and young child feeding in emergencies. Together we call for the active protection and support of breastfeeding during emergencies and the prevention and refusal of donations of breastmilk substitutes, bottles and teats that, too often, do more harm than good.

When an emergency strikes, simple measures can make all the difference in the world. Emergency preparedness is the key to quick appropriate actions. Mothers need to be secure and have priority access to food for the family, water, shelter and safe places to breastfeed.

The World Health Organisation (WHO) and UNICEF recommendations - early initiation and exclusive breastfeeding until six months of age and continued breastfeeding for two years or beyond - are even more critical in emergencies. Breastfeeding is the one safe and secure source of food and fluid for infants - instantly available, providing active protection against illness and keeping an infant warm and close to his/her mother. It also reduces the risk of post-partum haemorrhage in the mother, the leading cause of maternal mortality worldwide. In the challenging and risky environment of an emergency, how infants are fed is key to their survival.

Protecting breastfeeding and infant and young child feeding from inappropriate marketing influences is an essential component of emergency interventions. Violations of the International Code of Marketing of Breastmilk Substitutes and subsequent relevant WHA Resolutions are frequent. 

International guidance developed by the IFE Group clearly states that donations of breastmilk substitutes, bottles and teats should not be sought nor accepted in emergencies.

Everyone can play a positive and important role in emergency preparedness and response. Find out what you can do by consulting the WBW 2009 ACTION FOLDER produced by WABA and the IFE Core Group that includes an extensive Guide for Action.

‘Breastfeeding is a vital emergency response. When a disaster strikes, everyone should be ready!’

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TYPE 2 DIABETES: FDA APPROVES SAXAGLIPTIN, DPP-4 INHIBITORS

The U.S. Food and Drug Administration today approved Onglyza (saxagliptin), a once-daily tablet to treat Type 2 diabetes in adults. The medication is intended to be used with diet and exercise to control high blood sugar levels.

The hormone insulin keeps blood sugar (glucose) levels within a narrow range in people who don’t have diabetes. People with Type 2 diabetes are either resistant to insulin or do not produce enough insulin to maintain normal blood sugar levels.

Onglyza is in a class of drugs known as dipeptidyl peptidase-4 (DPP-4) inhibitors which stimulate the pancreas to make more insulin after eating a meal.

“Keeping blood sugar levels in adequate control is essential to the good health of the 24 million people in the United States with Type 2 diabetes,” said Mary Parks, M.D., director of the Division of Metabolism and Endocrinology Products in the FDA’s Center for Drug Evaluation and Research. “High blood sugar levels can cause blurry vision and excessive urination and eventually result in such serious conditions as kidney and eye disease.”

The most common side effects observed with Onglyza are upper respiratory tract infection, urinary tract infection, and headache. Other side effects include allergic-like reactions such as rash and hives.

Approval of Onglyza was primarily based on the results of eight clinical trials. The application seeking FDA approval was submitted before December 2008 when the agency recommended that manufacturers of new diabetes drugs carefully design and evaluate their clinical trials for cardiovascular safety. Although Onglyza was not associated with an increased risk for cardiovascular events in patients who were mainly at low risk for these events, the FDA is requiring a postmarket study that will specifically evaluate cardiovascular safety in a higher risk population.

Onglyza is manufactured by Bristol-Myers Squibb Co. of Princeton, N.J., and marketed by Bristol-Myers and AstraZeneca Pharmaceuticals LP, of Wilmington, Del.

A 'plagiarised paragraphs' in the reasearch that claimed to have created human sperm in the laboratory

The team claimed to have created human sperm from stem cells taken from an embryo which could one day lead to new treatments for infertility in men.

However other scientists in the field remained unconvinced that the cells were proper sperm and the cells had not been used to fertilise an egg.

The claims made headline news around the world after a study by researchers at Newcastle University was published in the journal Stem Cells and Development.

But Graham Parker, editor in chief of the journal, was told three days later that two paragraphs in the research paper had been plagiarised from a 2007 paper in another publication.

SWINE FLU A/H1N1: U.S. SITUATION UPDATE AT 31TH JULY

Percentage of Visits for Influenza-like Illness (ILI) Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet), National Summary 2008-2009 and Previous Two Seasons

SWINE FLU A/H1N1: NATIONS TABLE OF COMULATIVE CASES AT 31TH JULY

uman cases of influenza A(H1N1)v in the EU and EFTA countries Last update: 31 July, 17:00 CEST
Country	Confirmed cases reported in the last 24h	Cumulative number of confirmed cases	Deaths among confirmed cases*
Austria	22	153	-
Belgium	-	126	1
Bulgaria	-	36	-
Cyprus	-	297	-
Czech Republic	6	95	-
Denmark	7	254	-
Estonia	1	40	-
Finland	2	189	-
France**	-	719	1
Germany	738	6062	-
Greece	210	730	-
Hungary	4	86	1
Iceland	5	51	-
Ireland	-	276	-
Italy	357	975	-
Latvia	1	19	-
Lithuania	7	22	-
Luxembourg	-	52	-
Malta	7	157	-
Netherlands***	153	517	-
Norway	54	471	-
Poland	12	87	-
Portugal	28	291	-
Romania	21	164	-
Slovakia	5	52	-
Slovenia	5	128	-
Spain	-	1538	6
Sweden	14	511	-
Switzerland	39	462	-
UK	705	11864	30
TOTAL	2403	26424	39
Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
* Deaths are included in the cumulative number of confirmed cases  ** Cases reported from France include those reported from Reunion-Mayotte (5), Antilles-Guyane (8), French Polynesia (5) and French New Caledonia (34).  *** Cases from the Netherlands include those reported from Aruba and the Netherlands Antilles

SWINE FLU A/H1N1: COMULATIVE CASES. WORLD MAP AT 31TH JULY

SWINE FLU A/H1N1: INFECTION NUMBERS IN EUROPE AT 31TH JULY

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 30 July 2009, 17:00 hours CEST, is presented in TABLE 1.

Disclaimer: The number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher. Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.

Epidemiologic update

Out of the 31 EU and EFTA countries, 30 countries have reported a total of 26,424 confirmed cases of influenza A(H1N1)v infection, including 39 deaths. In the past 24 hours, 2,403 new cases and the first fatal case in France were reported from the EU and EFTA countries. Germany reported 738 new cases and the United Kingdom 705.

Outside of the EU and EFTA countries, a total of 3273 new cases have been reported within the last 24 hours. In total, 156,902 cases including 1109 fatal cases have been reported from non-EU and EFTA countries.

Globally, the total number of confirmed and reported influenza A(H1N1)v cases to date is 183,326, including 1,148 deaths.

 

 

 2403 new cases, including 738 new cases from Germany, 705 from the United Kingdom and the first death in France were confirmed and reported from the EU and EFTA countries, reaching a total of 26,424;

 

3273 new cases including 20 fatal cases, were reported from non-EU and EFTA countries, reaching a cumulative total of 156,902 cases;

 

ECDC compiled an update of the analysis of individual case notification at this link.

Restless legs syndrome: Find First Potential Pathogenic Mutation

An international team of researchers led by scientists at the Mayo Clinic campus in Florida have found what they believe is the first mutated gene linked to restless legs syndrome, a common neurologic disorder.

The researchers, who reported the findings in the July 21 issue of Neurology, doubt that a large proportion of the millions of people who suffer from the syndrome have this mutated MEIS1 gene. They point out, however, that understanding the function of both the normal and abnormal genes will shed some insights into this mysterious disorder.

Restless legs syndrome affects between 5 and 11 percent of the population in Europe and in North America. The condition is characterized by unpleasant sensations in the legs at rest, especially in the evening, that are temporarily relieved by movement. Because restless legs syndrome often interrupts sleep, people commonly are diagnosed after they consult a sleep specialist for assistance.

"We think restless legs syndrome may be due to a number of clinical factors, but we also believe that there is a strong genetic component to the disorder," says the study's lead investigator, Carles Vilariño-Güell, Ph.D., a neuroscientist at Mayo Clinic, Jacksonville.

"The mutation we found is in a portion of the protein that is identical in species as distinct to human as frogs and fish, which tells us that this portion is very important for the proper function of the protein and that the mutation has a very high chance of causing disease," he says.

While common variants (different versions) of MEIS1 and BTBD9, another associated gene, have been found in families with a high incidence of restless legs syndrome, it is not clear that those variants are capable of causing disease, Dr. Vilariño-Güell says. "This mutation, on the other hand, is the first that we think can be a real candidate for causing or promoting restless legs syndrome," he says.

Researchers did not find mutations in the BTBD9 gene in study participants, but they found one in the MEIS1 gene that resulted in the production of an aberrant protein. The family that has the MEIS1 mutation consists of six members. Three who had restless legs syndrome had the mutation and the other three without the disease did not. "The presence of the mutation in all affected individuals supports a pathogenic role for the MEIS1 gene, and we now need to confirm this finding with other international research groups who study restless legs syndrome," Dr. Vilariño-Güell says.

Researchers from Canada, Ireland, and Norway also participated in the study. In total 378 restless legs syndrome patients and 853 healthy participants were evaluated for the presence of this newly discovered mutation in their DNA. This analysis only identified one additional individual from Ireland who did not present any symptoms of restless legs syndrome. This suggests that the gene defect may need additional triggers to develop the syndrome, Dr. Vilariño-Güell says. "This gene is probably not the most common cause of restless legs syndrome in the population we studied, but it may be more prevalent in other regions of the world," he says.

IL 90% DEGLI ITALIANI CONOSCE I FARMACI EQUIVALENTI

Cresce il feeling tra gli italiani e i farmaci generici, nei confronti dei quali i nostri connazionali dimostrano oggi più informazione e fiducia. Lo rivela un’interessante ricerca condotta da Research International per ratiopharm, su un campione di 1.002 persone dai 18 ai 64 anni, residenti in tutta la Penisola. Obiettivo dell’indagine era sondare come sia cambiata negli ultimi due anni la percezione degli unbranded in Italia.

Mentre nel 2007 il 73% degli intervistati aveva sentito parlare di farmaci generici e solo il 30% di farmaci equivalenti, nel 2009 queste percentuali sono salite, rispettivamente, al 94% e al 77%. Non solo, dunque, il termine “generico” risulta essere identificativo della categoria dei farmaci unbranded, ma comincia ad affiancarglisi il più appropriato termine “equivalente”. In crescita risultano anche la quantità e la correttezza delle informazioni sulle caratteristiche distintive di questi farmaci, mentre compaiono sempre più spesso, nelle definizioni che ne danno gli italiani, termini come “eccipienti” e “brevetto”, ancora poco noti fino a due anni fa.

Tra quanti affermano di conoscere i medicinali generici (oltre 9 italiani su 10), oggi l’11% dichiara di “sapere esattamente di che cosa si tratta e avere un buon livello di conoscenza in materia”, contro l’8% del 2007, mentre a “sapere di che cosa si tratta e avere una discreta conoscenza dell’argomento” è il 47%, rispetto al 33% di due anni fa. Al contrario, il 31% del campione sostiene di “sapere più o meno di che cosa si tratta e avere poche conoscenze in merito”: un dato in calo, rispetto al 44% del 2007. Allo stesso modo, coloro che ne hanno “solo sentito parlare ma non ne sanno quasi nulla in merito” erano il 15% nel 2007 e si sono ridotti, nel 2009, all’11%.

Si tratta di un importante risultato, indice del buon lavoro svolto dagli operatori sanitari sul piano della comunicazione ai pazienti, che ha tra le conseguenze positive anche un notevole risparmio per il SSN e per le tasche dei cittadini. “Questa ricerca - ha dichiaratoMarco Grespigna, Direttore Commerciale di ratiopharm Italia - dimostra come l’impegno di medici, farmacisti ed Istituzioni, volto ad informare i pazienti sull’esistenza del farmaco equivalente, stia cominciando a dare i propri frutti. A questo aggiungerei l’impegno in comunicazione delle aziende del comparto, che purtroppo pochissimi oltre ratiopharm stanno implementando, con campagne media e web rivolte ai cittadini. Nella fattispecie, abbiamo pianificato fin dal 2008 campagne promo-informative su TV, stampa e soprattutto web, per sviluppare la notorietà del marchio ma anche per informare i cittadini sulla qualità, efficacia e sicurezza del farmaco equivalente”.

Emergono inoltre una fiducia sempre maggiore verso gli equivalenti e la predisposizione alla sostituzione del prodotto griffato con il farmaco generico, specie tra i soggetti con livello di istruzione medio-alto. Nel 2009, il 45% degli intervistati ha chiesto esplicitamente la sostituzione, contro il 24% del 2007. Alla domanda “se il farmacista le proponesse di sostituire il farmaco con ricetta con un farmaco generico”, il 35% ha risposto di “accettarlo sempre e comunque”, rispetto al 24% del 2007, mentre il 38% lo accetterebbe solo se “si sentisse tranquillo, ma di certo non tornerebbe dal medico a chiedere”, contro il 36% del 2007. Gli irriducibili della marca, che rifiutano sempre la sostituzione, si sono ormai ridotti a un esiguo 7%, rispetto al 9% di soli due anni fa.

SEASONAL INFLUENZA: 10 MILLION DOSES OF TRIVALENT NASAL SPRAY FLU VACCINE BY MEDIMMUNE

MedImmune announced that it has begun shipping its seasonal influenza vaccine FluMist (Influenza Vaccine Live, Intranasal) to vaccine distributors who service health care providers throughout the 

United States

. MedImmune expects approximately 10 million doses of its trivalent (three-strain) nasal spray flu vaccine will be available for the 2009-2010 influenza season through a variety of private health care practices, public health departments, school-based vaccination programs, military bases, and other locations.

The U.S. Centers for Disease Control and 

Prevention (CDC) and American Academy of Pediatrics

 advise that flu vaccine be administered every year as soon as it becomes available. A MedImmune analysis suggests that starting influenza vaccination in August instead of October may help reach an additional 11.5 million children at already-scheduled healthcare provider visits.

The 2009-2010 influenza season is the first for full implementation of the recommendations by the CDC's Advisory Committee on Immunization Practices (ACIP) that children six months through the age of 18 years be vaccinated annually against influenza, meaning 30 million additional children 5 through 18 years of age now fall within influenza vaccination recommendations.

"MedImmune is committed to delivering our seasonal nasal spray influenza vaccine in the summer months in order to increase opportunities for vaccination," said Alex Zukiwski, MD, MedImmune's Executive Vice President, 

Clinical Research & Chief Medical Officer

. "If more eligible children can be vaccinated against seasonal influenza while attending back-to-school checkups, sports physicals, and clinics early in the school year, the country will be better prepared for the flu season ahead."

FluMist is available in every state through the federally funded Vaccines for Children (VFC) program, which provides vaccines at no cost to eligible children. FluMist is also covered by approximately 95 percent of private health plans which offer immunization benefits.

FluMist Becomes Sponsor of Women's Professional Soccer

To help communicate the importance of seasonal flu vaccination efforts, MedImmune has teamed up with Women's Professional Soccer (WPS) for "Don't Play with the Flu"(TM) (www.dontplaywiththeflu.com), a national health awareness campaign with the goal of increasing seasonal flu vaccination rates among eligible kids and families across the country. As part of the multi-faceted campaign, FluMist has become an official sponsor of WPS, the world's premier women's professional soccer league, working with real-life soccer moms and the league to reach families during flu vaccination season, including back-to-school visits.

"Our 'Don't Play with the Flu' efforts are directed toward parents to help them understand the importance of annual influenza vaccination and reminds them not to wait to put up a defense against the flu, particularly with seasonal vaccine becoming available during the summer," said

Peter Greenleaf

, MedImmune's Senior Vice President, Commercial Operations, Corporate Development & Strategy. "We're proud to partner with the WPS in its inaugural season to bring this fun, educational and interactive campaign to the families across America."

Important Safety and Eligibility information for FluMist

Who may be eligible for FluMist (Influenza Vaccine Live, Intranasal)?

FluMist is a vaccine approved for the prevention of certain types of influenza disease in children, adolescents and adults 2-49 years of age. FluMist may not protect everyone who gets it. FluMist is for intranasal administration only.

Who may not be able to get FluMist?

FluMist is not right for everyone. FluMist must not be given to: people with history of hypersensitivity to eggs, egg proteins, gentamicin, gelatin or arginine; people with life-threatening reactions to previous influenza vaccinations; and children and adolescents receiving aspirin or aspirin-containing therapy. Children less than 24 months of age are not eligible for FluMist.

The following people may not be able to get FluMist or may be able to get it only in certain situations: people with asthma or active wheezing, or children less than 5 years of age with recurrent wheezing; people with a history of Guillain-Barre syndrome; people with a weakened immune system; people with long-term medical conditions including heart disease, kidney disease, and metabolic diseases, such as diabetes; and pregnant women.

If your child falls into one of these groups, be sure to tell your healthcare provider. They will decide if FluMist is right for your child.

What are the most common side effects of FluMist?

Most common side effects included runny nose or nasal congestion, sore throat, and fever. For a full list of side effects, please see section 6.1 in the following product information.